Health on agenda at outreach meeting

Cook health leaders discuss issues with
Senator Smith’s staff

COOK—Outreach directors for U.S. Sen. Tina Smith asked for input and received an earful from members of the Cook Hospital Board and other area healthcare leaders at a meeting here last week.

Outreach Director for Healthcare and Aging, Lindsay McLaughlin, and Range Area Director, Peter Makowski, were both on hand on behalf of the senator.

Cook Hospital Chief Executive Officer and Administrator, Teresa Debevec, stressed the importance of maintaining critical access status. “It is very important for us to maintain that designation. We would struggle without it,” she said.

Scenic River Chief Financial Officer, Keith Harvey, and Cook Hospital CFO, Kaylee Hoard, agreed and said the additional reimbursement of costs is critical. “I’ll say it three times: reimbursement, reimbursement, reimbursement...It’s very, very critical for us to get reimbursements.” Hoard said.

Workforce issues

Finding qualified staff is an increasing challenge for rural healthcare facilities, and it was a major topic of discussion at last week’s meeting. Debevec said it is difficult to keep certified nursing assistants, especially in the care center, which has forced the hospital to use “traveling agencies” in the last couple years. Director of the Cook Care Center, Joe Buria, said that he was setting up an online nursing assistant course. “I’m cautiously optimistic. CNAs are going on to their RN or LPN. In this CNA field, they can go and get matching pay at Menards or Walmart, and they’re not working the night shift,” said Buria. Makowski relayed that the concern is statewide, “It’s very difficult unless you really love the rural setting to get healthcare workers.” He said some areas have looked internally to high schools and offered students wanting to stay in the area, continuing education needed to enter the healthcare field.

Board member Don Potter spoke on childcare needs, saying the board has recently explored the idea of having a childcare facility at the hospital, in hopes of retaining that professional workforce. Debevec said she has received emails from staff not being able to work because of lack of child care. Makowski said, “I can tell you from Senator Smith’s travels, affordable daycare is a statewide concern.” Keith Harvey noted a lack of childcare options in the area, and that wages have not kept up with the cost of daycare. “So much of our support staff is of child-bearing age, and they are going to need that support,” he said.

Board member Julian Brzoznowski spoke on behalf of veterans healthcare issues and said the Cook Hospital would be a preferable location for veterans services, as compared to Ely. Makowski said that the area demographic results are the reason why Sterling Medical made the recommendation to the VA to have the service in Ely. He added, “In September, the clinics in Ely and Hibbing are going to fall directly under the VA. Sterling Medical will no longer be operating them.” Malowski noted the concerns and offered little solace, “The hope had been, and we are still working on, a choice program; the VA still struggles with it, but as you read the national news, the VA is struggling from the top on down.” He added, “We very much understand the rural veteran’s needs. We can question them on their choices of putting the clinic in Ely, but what it comes down to is why we are here today: rural healthcare workers and the struggles of rural health care. In some places we struggle just to get rural healthcare workers. We’d put VA clinics all over in every area but the stark reality is there is also a budget out there,” said Makowski.

Mental health, addiction, mining

Mental health and lack of beds was another concern that Makowski said he hears frequently, “Particularly in children and adolescence. That is something we are going to have to continue to work on.” Board member Barb Johnson spoke of the ambulance service having to take people to Fargo and the Twin Cities for emergency mental health care. “We’ve heard horror stories of people having to transport all over the state, and sometimes in the state of Minnesota, you might have one open bed. There is definitely a lack of mental health facilities.”

Addressing the opioid addiction crisis, Keith Harvey said, “From the clinical standpoint, over the last year and a half, we’ve taken a pretty aggressive approach in how our physicians are managing opioid usage. It hasn’t always been positive, but we have had significant success in reducing the amount of opioids being used and the quantity being prescribed and how we manage it.” Harvey continued, “I think we created a monster in health care…if you had pain, you were given an opioid medication, and now we have to pull that back. We look for other options and are finding other ways to manage pain.”

Before the meeting ended, board member Liz Dahl brought forth concerns from the area medical community about sulfide mining. Dahl cited a Minnesota Medicine publication written by an eight-member panel of physicians addressing medical concerns over the proposed PolyMet sulfide mining plans. Makowski assured Dahl he had seen the concerns and the information would passed on to other staff that would share the information with Senator Smith. “She is very much aware of all sides of the issue.”

Dahl further pressed Makowski, as the senator has recently been in support of the mining project. She said the Minnesota Medical Association, Minnesota Public Health Association, Minnesota Nurses Association, and the Minnesota Academy of Family Physicians have spoken out in concern for the adverse human health effects and acid pollution sulfide mining brings. Makowski said he would take all the information and pass it on.

Senator Tina Smith sits on the Health, Education, and Labor Pensions committee and is an honorary co-chair of the Rural Healthcare Caucus.